Ilko Semerdjiev was born in Gotse Delchev on 25 August 1959.
He graduated from the Dental Faculty of the Higher Medical  Institute (now Medical Academy) in Sofia.
He did post-graduate studies at the Institute of Public Health and the International Company Management Center in Sofia.
Later he studied Social Security Administration in Washington D.C., the USA, Health  Insurance Administration (Germany, University of Keele in the UK, the Hospital Management School in France and the Institute of Public Administration in Ireland) and International Health Management (Washington D.C., the USA, and the Public Health Institute in Spain).
Between  1990 and 1992 he was in charge of the Sofia City Hospital No 6.
1993 - Deputy Health Minister in the Berov cabinet.
1994-1998 - Programme Director of a PHARE programme for Bulgara with the Health Ministry.
1997-1999 - Member of the Higher Medicine Council, health institutions manager and a practicing dentist.
From February 1997 till 8 March 1999 he was Deputy Health Minister in the cabinets of Stefan Sofiyanski and Ivan Kostov.
 
In March 1999 Ilko Semerdjiev was appointed Director of the National Health Insurance Fund, which scandalized the public by having purchased 10 expensive cars before becoming operative.
Semerdjiev was member of the teams that worked out the legislation regulating the health insurance system, the health reform, and the medical professional associations.
Semerdjiev joined the renewed Kostov cabinet (early 2000) as Minister of Health.

Married,  with two children.